In patients with severe CKD, besides the traditional risk factors such as hypertension, dyslipidemia, Na+ overload, Ca2+ and serum phosphorus abnormalities, and chronic inflammation, cardiovascular disease in CKD may also be driven by specific risk factors including anemia and malnutrition, hormonal imbalances, soft tissue calcification, erythropoietin resistance, renal replacement therapy (RRT)-related electrolyte imbalance, and high PTH level. Here, PTH is linked to metabolic syndrome.